2015 ISAKOS Biennial Congress ePoster #1241

Does Manual Drilling Improve Healing of Bone-Hamstring Tendon Graft in Anterior Cruciate Ligament Reconstruction?

Matteo Maria Tei, MD,PhD, Perugia ITALY
Andrea Speziali, MD, Pittsburgh, PA UNITED STATES
Giacomo Placella, MD, Roma ITALY
Pierluigi Antinolfi, MD, Perugia ITALY
Giuliano Giorgio Cerulli, MD, Perugia, RM ITALY

Istituto di Recerca Traslazionale per L'Apparato Locomotore, Nicola Cerulli- Let People Move, Arezzo-Perugia, Italy, Arezzo, ITALY

FDA Status Not Applicable

Summary: Manual drilling can improve the biologic properties of bone-hamstring tendon graft healing. These results support the clinical findings, that manual drilling for ACL reconstruction could be effective in restoring faster graft function post-operatively and can be a viable choice for the orthopedic surgeon.



Manual drilling reducing the invasiveness of mechanical-thermal stress that is normally caused by traditional motorized drill bit, can implement the process of healing.
ACL reconstructions using semitendinosus tendon autograft were performed in 28 skeletally mature female New Zealand white rabbits and randomly divided into 3 groups and treated with 3 different techniques: group A (ACLR with motorized drilling, N=12); group B (ACLR with manual drilling, N=12); group C (Sham operation, control group, N=4). On group A, the tunnel was drilled with motorized device, on group B the same procedure was performed with manual drill bit, group C served as a control with sham surgical operation. The reconstructions were assessed histologically at 2, 4, 8 and 12 weeks.


showed that at 4 weeks, histologic analysis revealed that the tendon in the tunnel remains viable with initial aspects of remodeling in both groups. Anyway there was a much more organized collagen fiber continuity at the bone–fibrous tissue interface in manual drilling group (Group B), with better integration between the graft and bone with early mineralized chondrocyte-like tissue formation
In conclusions use of manual drilling during ACL reconstruction results in the development of a better graft-tunnel osteointegration during the early crucial weeks of healing. The use of
manual drilling to mechanical enhance osteointegration is a novel and simple method offering the potential of more physiologic and earlier healing.